Are clinical parameters valuable prognostic factors in childhood primitive neuroectodermal tumors?: A multivariate analysis of 105 cases

Background: Medulloblastoma is one of the most frequent brain tumors in children. Long-term survivors are often confronted with serious late sequelae, caused by the therapy. Therefore, prognostic markers must be identified that allow the children to be assigned to different treatment schedules accor...

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Bibliographic Details
Published in:Radiotherapy and oncology 2000-03, Vol.54 (3), p.229-238
Main Authors: Michiels, Erna M.C, Heikens, Janneke, Jansen, Mieke J.C.E, Oldenburger, Foppe, Voûte, Tom
Format: Article
Language:English
Subjects:
Adolescent
Brain Neoplasms - mortality
Brain Neoplasms - pathology
Brain Neoplasms - therapy
Child
Child, Preschool
Disease-Free Survival
Female
Humans
Infant
Male
Medulloblastoma
Medulloblastoma - mortality
Medulloblastoma - pathology
Medulloblastoma - therapy
Multivariate Analysis
Neuroectodermal Tumors, Primitive - mortality
Neuroectodermal Tumors, Primitive - pathology
Neuroectodermal Tumors, Primitive - therapy
Primitive neuro-ectodermal tumor
Prognosis
Prognostic factors
Survival Rate
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Summary:Background: Medulloblastoma is one of the most frequent brain tumors in children. Long-term survivors are often confronted with serious late sequelae, caused by the therapy. Therefore, prognostic markers must be identified that allow the children to be assigned to different treatment schedules according to their predicted outcome. Patients and methods: The medical data of 110 children with a medulloblastoma or central primitive neuroectodermal tumor (PNET), that were admitted to the Emma Kinderziekenhuis in Amsterdam were analyzed by univariate and multivariate analyses. Results: In univariate analysis the following characteristics had a significant influence on progression free survival (PFS): (a) presence of meningeal metastases at the time of diagnosis, (b) presence of tumor cells in the cerebrospinal fluid before or after surgery, (c) extent of resection, (d) necessity for permanent cerebrospinal fluid (CSF) shunting and (e) radiation dose to the posterior fossa. On multivariate analysis only the presence of metastases and the radiation dose to the posterior fossa retained significance. Conclusion: At the time of diagnosis, no reliable clinical prognostic markers are available for the majority of patients. Further molecular studies must be undertaken to identify such prognostic factors.
ISSN:0167-8140
1879-0887
DOI:10.1016/S0167-8140(00)00155-9